Sleep medicine expert says testing hospitalized patients for sleep apnea saves lives

Despite growing evidence that sleep apnea contributes to cardiovascular disease and can even make it worse, about 50% to 77% of hospitalized patients remain undiagnosed, according to a West Virginia University expert on sleep disorders.

Working with colleagues in the American Academy of Sleep Medicine, Dr. Sunil Sharma, N. Leroy Lapp Professor and chief of the Division of Pulmonary Critical Care and Sleep Medicine in the WVU School of Medicine, developed guidelines that can reduce deaths and improve quality of life for those with sleep apnea.

He will present those guidelines in his role as chair of the 2026 symposium of the American College of Chest Physicians, held in Phoenix on October 18, 2026. It is also published in the Journal of Clinical Sleep Medicine. Another paper is slated for publication in a special issue of Sleep Medicine Clinics.

Sharma says, “There are two high-risk groups that warrant screening and evaluation for sleep apnea during hospitalization. The first is patients with comorbidities strongly associated with sleep-disordered breathing, such as heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke and pulmonary hypertension. The second is patients who screen positive for classic signs and symptoms of disordered sleep—obesity, snoring, hypertension, excessive daytime sleepiness and fatigue.

“Randomized trials show improved survival in patients who are identified during hospitalization and start positive airway pressure therapy, or PAP therapy. Other positive patient outcomes from the screenings include better stroke recovery, reduced cardiovascular complications, fewer hospital readmissions and significant improvement in excessive daytime sleepiness—even decreased cost of care for the health care system.

“Our data suggest that this service may also help reduce health care disparities. Patients in rural Appalachia often face significant barriers to accessing care, with hospitalization serving as their first—sometimes only—point of contact with the medical system.

“Identifying sleep-disordered breathing, providing education and initiating treatment during hospitalization is a chance to offer therapy they would not otherwise receive. Our research also shows hospitals save lives when they provide patients who have chronic respiratory failure with noninvasive ventilation before discharging them.

“Clinicians should assess at-risk patients using a validated sleep apnea questionnaire, which could potentially be followed by a comprehensive assessment and objective screening by the hospital sleep medicine service, and may include overnight high-resolution pulse oximetry or a Type 3 home sleep apnea testing.”